The summer season, along with its potential for fluctuating high temperatures is approaching. The California Department of Public Health (CDPH) reminds long-term care (LTC) health facilities that the elderly and other health-compromised individuals are more susceptible to extremes in temperature and possible dehydration. Facility Administrators should monitor weather predictions for fluctuations in extreme temperatures and take extra precautions to be sure appropriate air conditioning equipment is well maintained and operating effectively.

Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications. Facilties should use portable fans and other temporary cooling devices when indicated.

CDPH recommends that facilities implement the following measures to keep residents and clients comfortable during extremely hot weather:

• Dress in lightweight, loose-fitting clothing.
• Keep residents well hydrated with particular attention to dependent residents.
• Minimize physical activities during the hottest parts of the day.
• Stay indoors and out of the sun during the hottest parts of the day.
• Use fans as indicated in the attached "Fast Facts" sheet on preventing summer heat injuries.
• Open windows where feasible if screens are intact, to allow fresh air to circulate.
• Use cool compresses, misting, showers, and baths to promote cooling.
• Avoid hot foods and heavy meals.
• Encourage frozen treats such as "popsicles" between meals.
• Keep a hydration station readily available to residents, family, and staff.
• Be alert to adverse changes in patient and resident conditions that may be heat related. Develop and implement a system to monitor hydration status and be prepared to take appropriate interventions.
• Pay special attention to patients with medications that make the patient susceptible to high temperatures, e.g., psychotropic medications.

Hot weather brings mosquitoes and the risk of contracting West Nile Virus (WNV). If mosquitoes are abundant, residents and clients should remain indoors in the early morning and at twilight, when mosquitoes are most active. Repellents should be used cautiously, especially on children and the elderly. For additional information on the use of chemical repellents, administrators or infection control practitioners should consult the Centers for Disease Control and Prevention (CDC) web site:
(http://emergency.cdc.gov/disasters/).

Licensing regulations require that all emergency/disaster-related occurrences that threaten the welfare, safety, or health of patients must be reported to the CDPH Licensing and Certification (L&C) Program. If your facility is affected by extreme heat conditions that compromise patient health and safety and/or require an evacuation, transfer, or discharge of patients, you must contact your CDPH L&C District Office.

Please follow these guidelines for reporting such occurrences:

During normal business hours (8:00 a.m. – 5:00 p.m.) contact the local CDPH, L&C District Office you customarily work with for your geographic location.

For after-hour reporting or if the local CDPH, L&C District Office is non-operational due to an emergency/disaster, follow the process below:

For facilities outside Los Angeles County, notify the:
State Office of Emergency Services Warning Center at (916) 845-8911
Ask that they notify the CDPH Duty Officer.

For facilities in Los Angeles County notify the:
Los Angeles County Operator at (213) 974-1234
Ask that they notify the on-call Health Facilities Inspection Division Supervisor.

Sincerely,

Orginal signed by Jean Iacino

Jean Iacino
Interim Deputy Director
Center for Health Care Quality

Attachment: "Fast Facts: Preventing Summer Heat Injuries"